Huntington's disease | National Institute of Neurological Disorders and Stroke (2023)

What is Huntington's disease?

Huntington's disease (HD) is an inherited disorder that causes nerve cells (neurons) in parts of the brain to gradually break down and die. The disease affects areas of the brain that help control voluntary (deliberate) movement, as well as other areas. People living with HD develop uncontrollable dance-like movements (chorea) and abnormal postures, as well as behavioral, emotional, thinking, and personality problems.

for example youuncontrolled movements in the person's fingers, feet, face, or upper body. These movements are signs of chorea. They can become more intense when the person is nervous or distracted; As HD progresses, the person's movements may become more extreme and obvious.

HD symptoms usually appear in middle-aged people (adult HD). They can also occur in children (juvenile HD), but this is rare. The disease worsens over time.

The first signs of HD can vary but usually include mild clumsiness or problems with balance or movement, cognitive or psychiatric symptoms (problems with thinking or emotions), and behavior changes.

For some people, chorea can make walking difficult, increasing the risk of falling. Some people with Huntington's disease don't develop chorea; Instead, they may become rigid (stiff) and move very little or not at all. This condition is called akinesia. Other people may start out with chorea but become rigid as the disease progresses.

In addition to chorea, some individuals have unusual rigid (unchanging) postures known as dystonia. The two movement disorders (kinesis and dystonia) can mix or alternate.

Other symptoms may include tremors (involuntary back and forth movements in the person's muscles) and unusual eye movements. Eye movements can occur early in the disease.

Physical changes can include slurred speech and problems swallowing, eating, speaking, and especially walking. People with Huntington's disease may lose weight because of problems eating, swallowing, choking, and chest infections. Other symptoms may include insomnia (difficulty sleeping), loss of energy, fatigue, and seizures. Finally, the person must remain in bed or in a wheelchair.

Changes in thinking (cognitive changes) It may involve problems with attention or judgment and difficulty solving problems or making decisions.

Other changes can include problems with direction, prioritization (deciding which things are most important and which are least important), and difficulty organizing, learning new things, remembering a fact, organizing thoughts, or answering a question.

These cognitive changes worsen as the disease progresses, until people with HD are unable to work, drive, or take care of themselves.

When the cognitive problems are so severe that the person is unable to function in daily life, the condition is known as dementia. But many people with HD remain aware of their surroundings and are able to express their emotions.

Behavior changes may include mood swings; irritability (grumpy); not be active; or feeling listless (disinterested), depressed, or angry. These symptoms may decrease as the disease progresses. However, in some people, symptoms can be persistent and include temper tantrums, suicidal thoughts, deep depression, and psychosis (loss of contact with reality). People with HD may withdraw from social activities.

Who is Most Likely to Get Huntington's Disease?

HD is a hereditary disease. It is passed from parent to child through a mutation (a change) in a specific gene.If a parent has HD, each child has a 50% chance of inheriting the copy of chromosome 4 that carries the HD mutation. If a child doesn't inherit the HD mutation, they won't develop the disease and won't be able to pass it on to future generations.When HD occurs without a family history, it is called sporadic HD.

Huntington's disease is caused by a mutation in the gene for a protein called huntingtin. The defect causes the building blocks of DNA called cytosine, adenine, and guanine (CAG) to repeat themselves much more often than they would normally.

Most people have fewer than 27 CAG repeats in their HD gene, so they are not at risk of developing the disease. People with CAG repeats in the middle range (27 to 35) are unlikely to develop the disease, but can still pass it on to future generations. People with HD can have 36 or more CAG repeats.

Every child of a parent with HD has a 50% chance of inheriting the HD gene. A child who does not inherit the HD gene will not develop the disease and usually cannot pass it on to their children or other future generations.

How is Huntington's disease diagnosed and treated?

Diagnose HD

Doctors typically use a combination of tests and other information to determine if a person has Huntington's disease. These include medical history, neurological and laboratory tests, brain imaging, and genetic testing.

  • Neurologic Examination and History - A neurologist will conduct a detailed interview to obtain a history (including any family history, called a pedigree or genealogy) to rule out other disorders. Neurological and physical exams can assess reflexes, balance, movement, muscle tone, hearing, gait, and mental status. Laboratory tests may also be ordered, and people with HD may be referred to specialists such as psychiatrists, genetic counselors, clinical neuropsychologists, or speech therapists for specialized treatment and/or diagnostic work-up.
  • Diagnostic imaging – In some cases, particularly when a person's family history and genetic testing are inconclusive, a doctor may recommend brain imaging, such as a brain scan. B. a computed tomography (CT) or, more likely, a magnetic resonance imaging (MRI). As the disease progresses, these scans often show shrinkage in parts of the brain and enlargement of fluid-filled cavities in the brain called ventricles. These changes are not necessarily indicative of HD, as they can also occur in other diseases. A person can have early symptoms of HD and still have normal findings on a CT scan or structural MRI.
  • Genetic testing - Genetic testing can confirm or rule out a suspected genetic condition or help determine a person's likelihood of developing or passing on a genetic disorder. Genetic testing makes it possible to predict with greater certainty whether someone will develop Huntington's disease.
    • The most effective and accurate method of testing for HD — called direct genetic testing — counts the number of CAG repeats in the HD gene using DNA taken from a blood sample. The presence of 36 or more repeats supports the diagnosis of HD. A test result of 26 or fewer replicates rules out HD.
    • An older genetic test called Linkage testing (also called prenatal exclusion testing) requires a DNA sample from an affected close relative, preferably a parent, to identify markers near the HD gene and determine if a fetus has inherited a chromosome 4 mutation from an affected grandparent. A version of the linkage method is sometimes used for prenatal testing.
    • Prenatal testing is an option for people with a family history of HD who are concerned about passing the disease on to a child. Prenatal testing can be performed using either the direct method or the linkage method. As with adult testing, the direct method offers more certainty.

Tratar not DH

There is no treatment that can stop or reverse HD, but some of the symptoms can be treated:

  • The drugs tetrabenazine and deuterabenazine can treat chorea associated with Huntington's disease
  • Antipsychotics can relieve chorea and help control hallucinations, delusions, and violent outbursts.
  • Medications may be prescribed to treat depression and anxiety.

Side effects of drugs used to treat HD symptoms can include fatigue, sedation, decreased concentration, restlessness, or over-excitability. These drugs should only be used if HD symptoms are causing problems for the person living with HD.

What are the latest updates on Huntington's disease?

Researchers are learning more about Huntington's disease over time. Below are some important updates that could improve how doctors treat this condition in the future.

Understanding the mechanisms of Huntington's disease

NINDS-funded researchers are trying to better understand the cellular and molecular mechanisms involved in HD, for example by studying how the huntintin protein affects cell signaling and how its altered structure may contribute to the disease. Below is an overview of this research:

  • A new line of research supported by NINDS is investigating whether additional changes in the HD gene during development and adulthood affect the onset and severity of the disease, and whether the HD gene affects the brain's overall ability to maintain healthy, healthy DNA damage influenced. This work is promising area for identifying novel modifiers of HD onset and progression that could be attractive drug targets.
  • Excessive chemical signaling between cells in the brain can lead to chronic overexcitation (overactivating neurons to turn them on), which is toxic to neurons. Several labs are investigating whether drugs that neutralize excitotoxicity can help fight HD.
  • Cutting-edge methods such as optogenetics (where neurons in the brains of living animals are activated or silenced with beams of light) are being used to study the cause and progression of cellular circuit defects in HD.


The NINDS-funded PREDICT-HD study and several international studies are working to identify and validate biomarkers for HD. Biomarkers are biological changes that can be used to predict, diagnose, or monitor a disease. One of the goals of PREDICT-HD is to determine whether disease progression correlates with changes in brain scan images or with chemical changes in blood, urine or cerebrospinal fluid. Another goal is to find measurable changes in personality, mood and cognition that typically precede the onset of HD motor symptoms. A third phase of PredictHD is underway.

A related study supported by NINDS aims to identify additional human genetic factors that influence disease progression. The search for genetic variants that slow or accelerate disease progression promises important new targets for disease intervention and therapy.

stem cells

Through a consortium funded by NINDS, researchers are using cell line cultures (grown from people with HD who have donated skin and blood samples for research) to understand why neurons in HD fail and die and to rapidly test potential new drugs . Another approach could be to mobilize pre-existing stem cells that can migrate to damaged tissue.

Turn research into treatment

Testing experimental drugs may lead to new treatments while improving our understanding of the disease process in HD. Drug classes tested include those that control symptoms, slow the rate of HD progression, block the action of excitotoxins, provide supportive factors that improve neuronal health, or suppress metabolic defects that contribute to the development and progression of HD -contribute disease.

Several groups of scientists use gene editing or specific molecules that can disrupt HTT production in cells or animals to reduce or eliminate HTT production.


Scientists are using imaging technology to find out how HD affects brain chemistry, characterize dead neurons, visualize changes in brain volume and structure in people with HD, and understand how HD affects function affecting different regions of the brain.

brain development

Altered brain development may play an important role in HD. Huntingtin is expressed during embryonic development and throughout life. Animal studies have shown that the normal HD gene is vital for brain development. Adults who carry the mutated HD gene but have not yet experienced symptoms show measurable changes in brain structure up to 20 years before clinical diagnosis.

A NINDS-funded study is examining brain structure and function in children, adolescents and young adults up to the age of 30 who are at risk of developing the disease because they have a parent or grandparent with HD. This study attempts to capture the potential impact of HD during the final stages of brain development. Participants who carry the expanded gene will be compared to people who carry the gene but have CAG repeats of 39 or fewer, and people who have no family history of HD. Changes in brain structure and/or function in the expanded gene cluster may indicate a developmental component in HD.

medical record

Learn more about clinical trials

Clinical trials are studies that allow us to learn more about diseases and improve care. You can help connect patients to new and upcoming treatment options.

How can I or my loved one help improve care for people with HD?

Consider participating in a clinical trial so doctors and scientists can learn more about HD. Human volunteers are used in clinical research to help researchers learn more about a disease and potentially find better ways to safely diagnose, treat, or prevent disease.

All kinds of volunteers are needed—those who are healthy or might have an illness or disease—of all ages, genders, races and ethnicities to ensure that the study results apply to as many people as possible and that the treatments are safe and effective for all who use them.

For information on participating in clinical trials, seeNIH Clinical Research Studies and You. Learn more about the clinical trials currently searching for people with

Where can I find more information about Huntington's disease?

Information may be available from the following organizations and resources:

Foundation for Hereditary Diseases
Phone: 212-928-2121

Huntington's Disease Society of America
Phone: 212-242-1968 or 800-345-4372

National Library of Medicine
Telephone: 301-594-5983 or 888-346-3656


What is the average life expectancy of a person with Huntington's disease? ›

The time from the first symptoms to death is often about 10 to 30 years.

What happens if you test positive for Huntington's disease? ›

What it's like to test positive for Huntington's disease. “When you find out you will eventually develop a terminal illness you can feel physically able for many years, but the impact it can have on your mental health can be so detrimental that it ruins the non-symptomatic years of your life.

What is the most promising treatment for Huntington's disease? ›

No treatments can alter the course of Huntington's disease. But medications can lessen some symptoms of movement and psychiatric disorders. And multiple interventions can help a person adapt to changes in abilities for a certain amount of time.

How old is the oldest person with Huntington's disease? ›

The range of disease duration was between 2 and 17 years, the oldest living to age 91.

What is the leading cause of death in Huntington's disease? ›

Huntington's disease (HD) is a progressive neurodegenerative autosomal dominant disease characterized by choreatic and hypokinetic movements, disturbed behaviour, and cognitive decline. Pneumonia is the most common cause of death, followed by cardiovasculair diseases.

How close are we to a cure for Huntington's? ›

There is currently no cure and no way to slow or stop these brain changes.

Do you lose your mind with Huntington's disease? ›

Huntington disease is a brain disorder in which brain cells, or neurons, in certain areas of your brain start to break down. As the neurons degenerate, the disease can lead to emotional disturbances, loss of intellectual abilities, and uncontrolled movements.

Which parent passes Huntington's disease? ›

There have been reports that juvenile onset Huntington's chorea is almost always inherited from the father, and that late-onset Huntington's chorea is inherited more often from the mother than from the father.

How painful is Huntington's disease? ›

Sprenger, MD, “Prevalence and the burden of pain in patients with Huntington disease: a systematic review and meta-analysis.” The February 2018 review, which analyzed 15 previous studies involving 2,578 patients, showed that the pain prevalence was 41.3%, and that the mean pain burden was 84 on a scale of 0 to 100.

What vitamins help with Huntington's? ›

Daily biotin and thiamine vitamin supplementation is an approved treatment for BTBGD, and has been used with success for individuals with this condition.

What is the new Huntington's drug? ›

Pridopidine is an oral small-molecule that binds and activates the Sigma-1 receptor (S1R), which is present at high levels within the brain. By activating S1R, the drug helps boost production of brain-derived neurotrophic factor, a protein with neuroprotective properties.

What is the new Huntington's disease breakthrough? ›

The Huntington's Disease Integrated Staging System (HD-ISS) groups together people with HD (PwHD) according to their underlying biological (including genetic), clinical, and functional characteristics. It is the first time ever a staging system has been developed for a genetic neurological condition.

Does a brain MRI show Huntington's disease? ›

To conclude neuroimaging, particularly MRI, remains a cornerstone in the diagnosis and assessing the severity of Huntington's disease. Genetic testing can be used to confirm the diagnosis if the family history is not forthcoming.

What are 3 interesting facts about Huntington's disease? ›

Some facts about Huntington's:
  • Huntington's is not something you can catch; it is inherited. ...
  • A genetic test can find out if you have the faulty gene.
  • You can live with the faulty gene for years without symptoms, but if you do have it, at some stage you will develop symptoms. ...
  • Huntington's disease affects men and women.

What is the youngest person with Huntington's? ›

Onset occurring ≤20 years is classified arbitrarily as juvenile-onset HD (JHD). The youngest symptomatic child documented had an age of onset of 18 months,3 with other children developing symptoms in their teens, meaning that some individuals with JHD may now be in their twenties.

What is the last stage of Huntington's disease? ›

Stage V (End-of-Life Stage)

Individuals are bedridden, nonverbal, and completely dependent on others for personal care and daily living tasks. Most patients with Huntington's disease stage V require around-the-clock skilled nursing care at an extended care facility.

What are the end of life symptoms of Huntington's disease? ›

Hospice referrals for Huntington's can be challenging because it's difficult to predict decline. Common end-of-life signals include significant weight loss, difficulty swallowing or breathing, recurrent aspiration pneumonia and uncontrolled pain.

What is the most common complication of Huntington's disease? ›

Pneumonia and heart disease are the two leading causes of death for people with HD. Additionally, HD patients have higher incidence of choking and respiratory complications, gastrointestinal diseases (such as cancer of the pancreas), and suicide than the non-HD population.

What activities should Huntington's patients do? ›

Persons with HD should engage in aerobic activities ideally for at least 150 minutes a week. Walking is a good aerobic exercise and still possible for the person in the middle stage of HD to perform. If available, stationary bikes are an excellent means of providing aerobic activity.

Can you live a normal life with Huntington's? ›

This disease often affects a person's ability to plan, make decisions, and process complex topics. But patients usually retain past memories, and are able to recognize people, objects, letters, numbers, and colors. They are often able to continue carrying out jobs that they have previously been doing for many years.

What is nice Huntington's disease? ›

Huntington's disease is a slowly progressive, neurodegenerative disorder characterised by chorea, incoordination, cognitive decline, personality changes, and psychiatric symptoms, culminating in immobility, mutism, and inanition. [1] Huntington's disease. Lancet.

Which brain areas are most damaged in Huntington's disease? ›

The major site of pathology in HD is the basal ganglia, which consists of striatal and pallidal subdivisions. The striatum consists of two major neuron types, projection neurons and interneurons, while globus pallidus consist mainly of projection neurons.

Can stress bring on Huntington's disease? ›

Although stress does not play a direct role in the onset and development of Huntington´s disease (HD) itself, it does have an influence on the course of the disease.

Do people with Huntington's disease sleep a lot? ›

Different patterns of sleep disturbances are observed in HD patients: insomnia, difficulties in falling asleep, frequent nocturnal awakenings, and excessive daytime sleepiness are the most common sleep problems reported by patients with HD.

Should you have kids if you have Huntington's? ›

A person with a Huntington's disease affected parent has a 50% risk of having inherited the Huntington's disease gene. Each child of that person has a 25% chance of inheriting the condition.

Does Huntington's miss a generation? ›

Myth 4: HD can skip generations. Fact: The HD gene mutation never skips a generation.

Does Huntington's get worse with each generation? ›

Researchers believe this long protein damages and kills brain cells. Anyone who inherits the gene will eventually develop HD symptoms. The exact age when symptoms appear varies. Often, HD symptoms start earlier in each new generation than in the previous generation.

Can Huntington's disease cause stroke? ›

Conclusion: Cerebrovascular disease is as common in patients with HD as in the general population, but minor cerebrovascular events and vascular risk factors may remain unrecognized. Genetic burden of the HTT mutation does not appear to increase the risk of stroke.

How does Huntington's disease affect walking? ›

Gait, or the way in which a person walks, is often impaired in people with HD. Walking slowly with irregular stepping patterns, and finding it hard to initiate each step are typical HD symptoms. These problems can affect quality of life as they limit an individual's ability to complete daily activities independently.

What essential oils help with Huntington's disease? ›

brain-supporting essential oils such as rosemary, frankincense and turmeric oil.

Why can't you eat with Huntington's disease? ›

Many symptoms of HD can interfere with eating: reduced voluntary motor control, involuntary movements, problems with chewing and choking, as well as changes to cognition that may cause the individual to become distracted and overwhelmed by mealtime activity.

Is Huntington's classed as a disability? ›

Does Huntington's Disease Qualify For Disability? Yes, many people with Huntington's are eligible for long term disability benefits. The symptoms are severe and progressive, and over time will make it difficult, or impossible, to continue working.

Is there a cure for Huntington's disease 2022? ›

Huntington's disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person's physical and mental abilities usually during their prime working years and has no cure.

How much does Huntington's treatment cost? ›

Average US costs have been estimated to be $4947 (£3150 in 2013 pounds) per person with HD in the early stage rising to $22 582 (£14 378 in 2013 pounds) in the late stage for commercial patients, and from $3257 (£2074 in 2013 pounds) in early stage Medicaid patients to $37 495 (£23 873 in 2013 pounds) in late stage ...

Has Huntington's been cured by gene therapy? ›

There's currently no cure for Huntington's disease, but there are types of gene therapy approaches that may offer hope for managing or slowing symptoms.

What foods help Huntington's disease? ›

Choose soft, easy-to-chew and easy-to-swallow foods (aim for the consistency of porridge). Use plenty of sauces and gravies to help make main meals easier to swallow. Add plenty of custards, ice-cream and cream to desserts. Avoid hard foods such as nuts and lollies.

What is Huntington's disease misdiagnosed as? ›

The presence of psychotic symptoms in premanifest Huntington's disease can be particularly misleading because, together with progressive apathy and cognitive impairment (mistaken for negative symptoms), they may lead to an erroneous diagnosis of schizophrenia.

How can a neurologist help with Huntington's disease? ›

Because the nervous system is complex, a neurologist may specialize in a specific area, like movement disorders. Movement disorders are associated with changes in the brain cells that help us move. They will assess, manage, and treat; they are your “team leader”.

Is dementia seen in Huntington's? ›

Huntington's disease is an inherited genetic condition that causes dementia. It causes a slow, progressive decline in a person's movement, memory, thinking and emotional state.

What is the average age of death for someone with Huntington's? ›

Huntington's disease is an inherited condition that causes involuntary muscle movements and changes in cognition and behavior. Many people live for many years without symptoms. After symptom onset, people live about 15 to 18 years but may live longer than 25 years.

What are the 5 stages of Huntington's disease? ›

What Are The 5 Stages Of Huntington's Disease?
  • Stage 1: Preclinical Stage.
  • Stage 1: Early Stage.
  • Stage 2: Early Intermediate Stage.
  • Stage 3: Late Intermediate Stage.
  • Stage 4: Early Advanced Stage.
  • Stage 5: Advanced Stage.
  • Treating Someone With Huntington's Disease.
Sep 21, 2022

Does Huntington's disease get worse with age? ›

After Huntington's disease starts, a person's functional abilities gradually worsen over time. The rate of disease progression and duration varies. The time from the first symptoms to death is often about 10 to 30 years.

What actress has Huntington's? ›

Filmmaker and actress Marianna Palka knew she was at risk for fatal and untreatable neurodegenerative illness Huntington's disease as her father has the disease; his illness, which became symptomatic when she was eight years old, meant his children had a 50% risk of inheriting the disease.

What famous people died of Huntington's? ›

Like ALS, whose eponymous sufferer was baseball player Lou Gehrig, Huntington's has a famous victim — the folk singer Woody Guthrie, who died in 1967. Both diseases proceed unabated once their symptoms appear.

How did Huntington's disease start? ›

The Genetic Cause of HD

HD is caused by mutation in a gene located on chromosome 4. This gene is found in every human being, and contains a CAG repeat sequence. We have not yet discovered the gene's normal function. In a case of HD, the gene contains an abnormally large number of CAG repeats.

Is Huntington's disease always fatal? ›

Huntington's disease is a condition that stops parts of the brain working properly over time. It's passed on (inherited) from a person's parents. It gets gradually worse over time and is usually fatal after a period of up to 20 years.

What happens in end stage Huntington's disease? ›

In Huntington's advanced stage, patients are totally dependent on others for their care. They can't walk or communicate with their loved ones, although they are generally able to understand what is being said and who everyone is.

How Long Does Stage 3 Huntington's disease last? ›

Stage 3: Late Intermediate Stage

Generally, the disease will have affected them enough that they will require assistance with everyday tasks. This stage will generally carry on for around five to sixteen years.

Can Huntington's cause strokes? ›

Conclusion: Cerebrovascular disease is as common in patients with HD as in the general population, but minor cerebrovascular events and vascular risk factors may remain unrecognized. Genetic burden of the HTT mutation does not appear to increase the risk of stroke.

Can you slow down Huntington's disease? ›

There's currently no cure for Huntington's disease or any way to stop it getting worse. But treatment and support can help reduce some of the problems caused by the condition.

What part of the body does Huntington's disease affect first? ›

Huntington's disease is a condition that damages nerve cells in the brain causing them to stop working properly. It's passed on (inherited) from a person's parents. The damage to the brain gets worse over time. It can affect movement, cognition (perception, awareness, thinking, judgement) and mental health.

What does late stage Huntington's look like? ›

At this stage, a person with Huntington's is no longer able to work or manage their own finances, personal care and domestic responsibilities, and will have difficulty with mobility, needing to be in a chair or bed most of the time. Swallowing may be difficult and there may be significant weight loss.

Does caffeine affect Huntington's disease? ›

A study found caffeine to be associated with earlier age of onset of Huntington's disease (HD) at intakes >190 mg/d, but studies in animal models have found equivocal results. Caffeine is protective in AD and PD at dosages equivalent to 3-5 mg/kg.

Can stress make Huntington's disease worse? ›

It is important to know that stress can lead to complications and the worsening of symptoms in people with HD.


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